title: Can quality from a care ethical perspective be assessed? A review.
abstract: BACKGROUND
  Ethics-of-care theories contain important notions regarding the quality of care; however, until now, concrete translations of the insights into instruments are lacking. This may be a result of the completely different type of epistemology, theories and concepts used in the field of quality of care research.
  
  
  OBJECTIVE
  Both the fields of 'ethics of care' and 'quality of care' aim for improvement of care; therefore; insights could possibly meet by focusing on the following question: How could ethics-of-care theories contribute to better quality in care at a measurement level? This study reviews existing instruments with the aim of bridging this gap and examines the evidence of their psychometric properties, feasibility and responsiveness.
  
  
  METHODS
  A systematic search of the literature was undertaken using multiple electronic databases covering January 1990 through May 2012.
  
  
  RESULTS
  Of the 3427 unique references identified, 55 studies describing 40 instruments were selected. Using a conceptual framework, an attempt was made to distinguish between related concepts and to group available instruments measuring different types of concepts. A total of 13 instruments that reflect essential aspects of ethics-of-care theory were studied in greater detail, and a quality assessment was conducted.
  
  
  CONCLUSIONS
  Three promising qualitative instruments were found, which follow the logic of the patient and take their specific context into account.
authors.affiliation: University of Humanistic Studies, The Netherlands esther.kuis@phd.uvh.nl.
authors.forename: Esther E
authors.initials: EE
authors.lastname: Kuis
authors.affiliation: Radboud University Nijmegen Medical Centre, The Netherlands.
authors.forename: Gijs
authors.initials: G
authors.lastname: Hesselink
authors.affiliation: University of Humanistic Studies, The Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Goossensen
mesh_terms: D003625:Data Collection / Q000379:methods* / Q000592:standards; D026689:Ethical Analysis / Q000379:methods*; D006801:Humans; D015397:Program Evaluation / Q000379:methods* / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards; D011787:Quality of Health Care
keywords: Ethics of care; instruments; quality of care; systematic review